Transcript RADIOLOGY AND DIAGNOSTIC IMAGING

CHAPTER 20
Radiology and
Diagnostic Imaging
Radiology and
Diagnostic Imaging Overview
• X-rays
– High-energy electromagnetic waves
– Travel in straight lines
– Shorter wave length than visible light
– Able to penetrate solid materials of varying
densities
– Capable of exposing a photographic plate
(X-ray film)
• Much the same way as a camera exposes film
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Radiology and
Diagnostic Imaging Overview
• X-rays
– Used to visualize internal organs and
structures of body
– Provide valuable means for verifying
presence of illness or disease
• Radiology
– Study of the diagnostic and therapeutic uses
of X-rays
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PROCEDURES
AND TECHNIQUES
Radiology and
Diagnostic Imaging
Angiocardiography
(Cardiac Catheterization)
• Pronounced
– (an-jee-oh-kar-dee-OG-rah-fee)
– (CAR-dee-ak kath-eh-ter-ih-ZAY-shun)
• Defined
– Specialized diagnostic procedure in which a
catheter is introduced into a large vein or
artery
– Usually of an arm or a leg, and is then
threaded through circulatory system to the
heart
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Angiography
• Pronounced
– (an-jee-OG-rah-fee)
• Defined
– Series of X-ray films allowing visualization of
internal structures after the introduction of a
radiopaque substance
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Cerebral Angiography
• Pronounced
– (seh-REE-bral an-jee-OG-rah-fee)
– (SER-eh-bral an-jee-OG-rah-fee)
• Defined
– Injection of a radiopaque contrast medium
into an arterial blood vessel (carotid, femoral,
or brachial) to make visualization of the
cerebral vascular system via X-ray possible
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Renal Angiography
• Pronounced
– (REE-nal an-jee-OG-rah-fee)
• Defined
– X-ray visualization of internal anatomy of the
renal blood vessels (blood vessels of the
kidney) after injection of a contrast medium
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Arteriography
• Pronounced
– (ar-tee-ree-OG-rah-fee)
• Defined
– X-ray visualization of arteries following the
introduction of a radiopaque contrast medium
into the bloodstream through a specific vessel
by way of a catheter
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Arthrography
• Pronounced
– (ar-THROG-rah-fee)
• Defined
– Process of taking X-rays of the inside of a
joint, after a contrast medium has been
injected into the joint
• Contrast medium makes the inside of the joint
visible
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Barium Enema (BE)
• Pronounced
– (BAH-ree-um EN-eh-mah)
• Defined
– Infusion of a radiopaque contrast medium,
barium sulfate, into the rectum
– Contrast medium is retained in lower
intestinal tract while X-ray films are obtained
of the lower GI tract
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Barium Swallow
(Upper GI Series)
• Pronounced
– (BAH-ree-um SWALL-oh)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows into the
esophagus as the person swallows
• X-rays are taken as barium sulfate flows into the
upper GI tract
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Bronchography
• Pronounced
– (brong-KOG-rah-fee)
• Defined
– Bronchial examination via X-ray following the
coating of the bronchi with a radiopaque
substance
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Cholangiography
(Intravenous)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Visualizing and outlining of the major bile
ducts following an intravenous injection of a
contrast medium
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Cholangiography
(Percutaneous Transhepatic)
• Pronounced
– (koh-lan-jee-OG-rah-fee)
– (per-kyoo-TAY-nee-us trans-heh-PAT-ik)
• Defined
– Examination of bile duct structure using a
needle to pass directly into an intrahepatic
bile duct to inject a contrast medium
• Also known as PTC or PTHC
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Cholangiopancreatography
(Endoscopic Retrograde)
• Pronounced
– (koh-lan-jee-oh-pan-kree-ah-TOG-rah-fee)
– (en-doh-SKOP-ic RET-roh-grayd)
• Defined
– Procedure that examines the size of and the
filling of the pancreatic and biliary ducts
through direct radiographic visualization with a
fiberoptic endoscope
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Cholecystography
(Oral)
• Pronounced
– (koh-lee-sis-TOG-rah-fee)
• Defined
– Visualization of the gallbladder through X-ray
following the oral ingestion of pills containing
a radiopaque iodinated dye
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Cineradiography
• Pronounced
– (sin-eh-ray-dee-OG-rah-fee)
• Defined
– Diagnostic technique combining the
techniques of fluoroscopy, radiography, and
cinematography by filming the images that
develop on a fluorescent screen with a movie
camera
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Computed Axial
Tomography (CT, CAT)
• Pronounced
– (kom-PEW-ted AK-see-al toh-MOG-rahfee)
• Defined
– Painless, noninvasive diagnostic X-ray
procedure using ionizing radiation that
produces a cross-sectional image of the body
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Computed Axial Tomography
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Voiding Cystourethrography
• Pronounced
– (VOYD-ing sis-toh-yoo-ree-THROG-rahfee)
• Defined
– X-ray visualization of the bladder and
urethra during the voiding process, after the
bladder has been filled with a contrast
material
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Digital Subtraction Angiography
(DSA)
• Pronounced
– (DIJ-ih-tal sub-TRAK-shun an-jee-OG-rahfee)
• Defined
– X-ray images of blood vessels only, appearing
without any background, due to the use of a
computerized digital video subtraction
process
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Echocardiography
• Pronounced
– (ek-oh-kar-dee-OG-rah-fee)
• Defined
– Diagnostic procedure for studying the
structure and motion of the heart via
ultrasound
• Useful in evaluating structural and functional
changes in a variety of heart disorders
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Fluoroscopy
• Pronounced
– (floor-or-OSS-koh-pee)
• Defined
– Radiological technique used to examine the
function of an organ or a body part using a
fluoroscope
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Hysterosalpingography
• Pronounced
– (his-ter-oh-sal-ping-OG-rah-fee)
• Defined
– X-ray assessment of uterus and fallopian
tubes by injecting a contrast material into
these structures
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Lymphangiography
• Pronounced
– (lim-fan-jee-OG-rah-fee)
• Defined
– X-ray assessment of lymphatic system
following injection of a contrast medium into
lymph vessels in the hand or foot
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Magnetic Resonance Imaging
(MRI)
• Pronounced
– (mag-NET-ik REZ-oh-nans IM-ij-ing)
• Defined
– Noninvasive scanning procedure that
provides visualization of fluid, soft tissue, and
bony structures without the use of radiation
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Mammography
• Pronounced
– (mam-OG-rah-fee)
• Defined
– Process of taking X-rays of the soft tissue of
the breast to detect various benign and/or
malignant growths before they can be felt
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Myelography
• Pronounced
– (my-eh-LOG-rah-fee)
• Defined
– Introduction of contrast medium into the
lumbar subarachnoid space through a lumbar
puncture to visualize the spinal cord and
vertebral canal through X-ray examination
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Positron Emission
Tomography Scan (PET)
• Pronounced
– (POZ-ih-tron ee-MISH-un toh-MOG-rah-fee)
• Defined
– Noninvasive diagnostic imaging method that
demonstrates the biological function of the
body before anatomical changes take place
• Scan produces computerized radiographic images
of the body structures when radioactive substances
are administered to the patient
– Substances are inhaled or injected
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Pyelography
(Intravenous) (IVP)
• Pronounced
– (pye-eh-LOG-rah-fee)
– (in-trah-VEE-nus)
• Defined
– Radiographic procedure that provides
visualization of the entire urinary tract:
kidneys, ureters, bladder, and urethra
• Also known as intravenous pyelogram or excretory
urogram
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Radiation Therapy
• Pronounced
– (ray-dee-AY-shun THAIR-ah-pee)
• Defined
– Delivery of ionizing radiation to accomplish
one or more of the following:
•
•
•
•
•
Destruction of tumor cells
Reduction of tumor size
Decrease in pain
Relief of obstruction
To slow or stop the spread of cancer cells
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Radiation Therapy
• Radiation therapy
– Destroys rapidly multiplying cells regardless
of whether they are cancerous
– Goal is to reach maximum tumor control with
no, or minimal, normal tissue damage
– May be delivered by teletherapy (external)
– May be delivered by brachytherapy (internal)
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Radioactive Iodine Uptake
• Pronounced
– (ray-dee-oh-AK-tiv EYE-oh-dine UP-tayk)
• Defined
– Examination that determines the position,
size, shape, and physiological function of the
thyroid gland through the use of radionuclear
scanning
• Image of the thyroid is recorded and visualized
after a radioactive substance is given
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Scanning
(Bone, Brain, Liver, Lungs)
• Pronounced
– (SCAN-ing)
• Defined
– Scanning is the process of recording emission
of radioactive waves, using a gamma camera
(scanner)
• After an intravenous injection of a radionuclide
material into the particular part of the body being
studied
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Scanning
(Bone, Brain, Liver, Lungs)
• Defined
– Image of the area being studied is
displayed by recording concentration or
collection of a radioactive substance
specifically drawn to that area
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Scanning
• Bone
– Involves intravenous injection of a
radionuclide material absorbed by bone tissue
• Used to detect spread of cancer to the bones,
osteomyelitis, and other destructive changes in the
bones
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Scanning
• Brain
– Nuclear scanning of cranial contents two
hours after an intravenous injection of
radioisotopes
• Useful in diagnosing abnormal findings such as an
acute cerebral infarction, cerebral neoplasm,
cerebral hemorrhage, brain abscess, aneurysms,
cerebral thrombosis, hematomas, hydrocephalus,
cancer metastasis to the brain, and bleeds
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Scanning
• Liver
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the liver after the IV injection
of a radioactive compound
• Useful in detecting cysts, abscesses, tumors,
granulomas, or diffuse infiltrative processes
affecting the liver
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Scanning
• Lung
– Visual imaging of the distribution of ventilation
or blood flow in the lungs by scanning the
lungs after the patient has been injected with
or has inhaled radioactive material
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Scanning
• Spleen
– Noninvasive scanning technique that enables
the visualization of the shape, size, and
consistency of the spleen after injection of
radioactive red blood cells
• Useful in detecting damage, tumors, and other
problems
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Single-Photon Emission
Computed Tomography (SPECT)
• Pronounced
– (single FOH-ton ee-MISH-un
kom-PEW-ted toh-MOG-rah-fee)
• Defined
– Nuclear imaging procedure that shows how
blood flows to tissues and organs
• Tracking of radioactive material allows physician to
see perfusion of blood to tissues and organs
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Small Bowel Follow-Through
• Pronounced
– (Small Bowel Follow-Through)
• Defined
– Oral administration of a radiopaque contrast
medium, barium sulfate, which flows through
the GI system
• X-ray films are obtained at timed intervals to
observe progression of barium through small
intestines
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Tomography
• Pronounced
– (toh-MOG-rah-fee)
• Defined
– X-ray technique used to construct a detailed
cross-section, at a predetermined depth, of a
tissue structure
• Useful in identifying space-occupying lesions in
the liver, brain, pancreas, and gallbladder
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Ultrasonography
(Ultrasound)
• Pronounced
– (ull-trah-son-OG-rah-fee)
• Defined
– Procedure in which sound waves are
transmitted into body structures as a small
transducer is passed over the patient’s skin
• Sound waves are reflected back into the transducer
and are interpreted by a computer that converts
waves to a composite picture form
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Ultrasonography
• Abdominal ultrasound
– Use of reflected sound waves to provide
reliable visualization of the liver, gallbladder,
bile ducts, pancreas, kidneys, bladder, and
ureters
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Ultrasonography
• Pelvic ultrasound
– Noninvasive procedure that uses highfrequency sound waves to examine the
abdomen and pelvis
– Can be used to locate a pelvic mass, an
ectopic pregnancy, or an intrauterine device,
and to inspect and assess the uterus, ovaries,
and fallopian tubes
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Ultrasonography
• Renal ultrasound
– Noninvasive ultrasound of the kidneys that is
useful in distinguishing between fluid-filled
cysts and solid masses, detecting renal
calculi, identifying obstructions, and evaluating
transplanted kidneys
• Thyroid Echogram (ultrasound)
– Ultrasound examination important in
distinguishing solid thyroid nodules from cystic
nodules
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Venography
• Pronounced
– (vee-NOG-rah-fee)
• Defined
– Technique used to prepare an X-ray image of
veins
– Veins are injected with a radiopaque contrast
medium
– Phlebography
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X-rays
• Pronounced
– (ECKS-rays)
• Defined
– Use of high-energy electromagnetic waves,
passing through the body onto a photographic
film, to produce a picture of the internal
structures of the body for diagnosis and
therapy
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X-rays
• Chest X-ray
– Visualization of interior of chest
– Provides diagnostic information about:
• Tumors, inflammation, accumulation of fluid,
accumulation of air, bone fractures, diaphragmatic
hernia, size of heart, calcification, placement of
centrally located intravenous access devices
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X-rays
• Chest X-ray views
– Posteroanterior (PA)
• X-rays pass through the posterior (back) to the
anterior (front)
– Lateral
• X-rays pass through the person’s side
– Oblique
• X-rays are taken from different angles
– Decubitus
• X-rays are taken with person in recumbent lateral
position – aids in localizing fluid
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